结直肠癌术中腹腔植入氟尿嘧啶缓释剂的Meta分析

Intraperitoneal implant of sustained-release fluorouracil during operation for colorectal cancer: a meta-analysis

目的系统评价氟尿嘧啶缓释剂治疗结直肠癌的疗效及安全性。方法通过计算机检索CNKI、CBM、VIP、WanFang Data、PubMed和EMbase(1990-2013年),收集所有氟尿嘧啶缓释剂治疗结直肠癌的随机对照试验(RCT),按照纳入和排除标准选择文献、提取资料,并在评价纳入研究的方法学质量后,采用RevMan5.0软件进行Meta分析。结果共13个RCTs纳入研究,Meta分析结果显示,治疗组术后2年的局部复发率和死亡率均低于对照组,而2组术后2年的远处转移率、切口感染率、腹膜炎发生率、吻合口瘘发生率以及肠梗阻发生率的差异均无统计学意义。结论术中植入氟尿嘧啶缓释剂能较好地降低患者术后2年的局部复发率和死亡率,而无法阻止患者远处转移发生的概率,可并不增加患者术后并发症的发生率,但其长期疗效和更全面的安全性尚需开展更多大样本、高质量的RCT加以验证。

Objective To evaluate the clinical efficacy and safety of intraoperative implant of sustained - release fluorouracil for colorectal cancer （CRC） to provide evidence - based medicine for drug using in clinic. Methods The following databases CNKI, CBM, VIP, WanFang Data, PubMed and EMbase were searched electronically and traced related references. All randomized controlled trials （RCTs） on intraoperative implant of sustained - release fluorouracil for colorectal cancer were collected. According to inclusive criteria, the literature was screened to extract data, and the quality of included studies were assessed. The meta -analysis was conducted using RevMan 5.0 software. Results A total of 13 RCTs were included, compared with the control group,the meta - analysis showed the treat- ment group was lower in 2 - year local recurrence rate and 2 - year mortality rate, but had no difference in 2 - year distant metastasis rate, wound infection, peritonitis, anastomotic leakage and intestinal obstruction. Conclusion Compared with the control group, intraoperative implant of sustained - release fluorouracil during operation could decrease 2 - year local recurrence rate and 2 - year mortality rate, but could not prevent 2 - year distant metastasis rate, without increasing its postoperative complications. But it＇s long - term curative effect and more comprehensive safety still needs to be further verified by more large sample and high quality RCTs.